Improving the Sad State of Affairs in Practice Management By: Gordon J. Christensen, DDS, MSD, PhD

How much education about practice administration did you receive in dental school? If you were a typical dental student, this area was among the most lacking in your curriculum. Most new dentists are woefully unprepared in their practice management skills, and they feel inadequate to handle the business aspects of owning a dental practice. Fortunately, most new dentists are associating with more experienced dentists, enrolling in a residency or specialty program, or working as an employee of a company. When compared to the past, few dentists now start their own practices. As a result, the challenges associated with their practice administration inadequacies are postponed for a few years. However, eventually almost all dentists have to learn practice administration skills to manage their own practice.

I feel that many dentists operate a production level significantly below their potential. It is possible for a typical general dentist to produce much more dentistry than the level reported by the American Dental Association surveys. How can dentists provide more service to more people than is currently being provided? I have assisted many new dentists in starting their practices, and I have seen their struggles as they have attempted to understand the necessities of administering a dental practice. This article discusses numerous aspects of practice administration that I feel are pertinent to successfully administering the business aspects in your practices.

ORGANIZATION
Few people have excellent organizational skills. It is my belief that much of the success we see in any aspect of life can be attributed to good organizational skills. Amazing as it may sound, many dentists do not have planning devices such as PDAs (Personal Digital Assistants) or paper planners. I suggest that dentists obtain either a paper or electronic planning system, such as the Franklin Covey system (www.franklincovey.com). I use both a paper and electronic planner system. I feel that the electronic concept is better for day-to-day scheduling, and the paper systems are better for long-term planning.

A person who plans and schedules his or her life is far more productive and calm, knowing that they cannot do much more than the tasks listed in their planner. Worry about missing an event is eliminated and anxiety level can be greatly reduced. If you do not have an organizational system, obtain one today.

GOALS Many dentists bumble into dentistry without any plan about what they want to accomplish. Often, they do not know the level of activity that is possible with adequate planning. The ADA has statistics available that describe a typical American practice (800-621-8099). In my opinion, a dentist with goals, organization, work ethic and drive can produce at least twice the average reported level of dentistry and its resulting income.

I suggest that all practitioners take the time to determine the level of activity they want in their practices, the income they need to support their families, and the time each week they want to practice.

Although I am far beyond the average age for dentists, I have been able to significantly increase my practice productivity with each decade of my life. At the same time, I have been able to reduce my hours in the office to provide more time for family, church, civic activities, hobbies, and service to the profession and the community. I suggest that all dentists contemplate the goals they want to achieve–not only in dentistry, but also in life–and work to achieve them.

EMPLOYEES
With a few exceptions, I have been blessed to have unbelievable employees over my entire career. These wonderful people have allowed me to accomplish many times more dentistry than I would have been able to accomplish if I had mediocre employees. Some dentists feel it is better to pay employees a minimum amount, and replace them as they inevitably leave. I have the opposite opinion. After employees have proven themselves, I prefer to continue to raise their salary to the level that they cannot find a position at their educational level that pays more. I suggest that dentists find the very best persons for the positions in their practices, and that they pay salaries that will retain these people. I have worked in many civic and church environments where I have had to do most of the work myself. Many dentists operate their practices with the same orientation. It is my observation that my productivity is grossly reduced when I am forced to work without adequate clinical, administrative, and secretarial help. I suggest that dentists determine what jobs are necessary in their practices and continue to seek the right personnel for those jobs until they are found.

STAFF MEETINGS
Would you believe that many dentists do not have staff meetings on a regular basis? How can a practice be productive when there is no communication and input among staff members? In my opinion, staff meetings are essential. I prefer to have these meetings at least once each month for 30 to 45 minutes before the patient day begins. I do not have long meetings in any aspect of my life. I prefer to delegate responsibilities to staff members before the scheduled meeting, and have them report on their assignment during the staff meeting. Often, the assignment requires some investigation or survey to be accomplished before the meeting. At the staff meeting, each staff member reports on his or her own area of practice responsibility. Decisions are made on the basis of the pre-meeting preparation. A true dental team can be developed using this concept.

COMPUTERIZATION
Most dentists have some form of computerization for the business aspects of practice. This is certainly to be encouraged. The software that is available is impressive when compared to the past, and is relatively easy to understand and use. As all of us know, the major challenges with computer software and hardware in dental offices is the constant upgrading and change that occurs. I have replaced computer systems several times over the years. Each time has cost the practice significant time and money; nevertheless, the incorporation of an excellent computer software system into a practice gradually saves time and effort. The move toward computerization in dental operatories, digital patient education, digital radiography, computerized restorative dentistry, and digital photography is excellent, but expensive. I suggest that dentists inc-orporate as much computerization in their practice as their interest and budget allow.

EDUCATIONAL SESSIONS
May I suggest that dentists incorporate in-service education sessions for their staff into their practice routines? The practice management area needs input from all of the staff. Questions such as: What is the right fee for a specific service? How long should a technique require? How should patients be greeted? How to integrate dental hygiene with other oral services; breaks; practice hours; education of front desk personnel; continuing education for staff; policies on late or disappointing patients; new clinical techniques or products, and many other subjects can be discussed in an in-service session. More efficient practice management is the result of regular in-service sessions.

CONCLUSIONS
Efficient practice management requires effort not only on the part of the dentist, but also from the entire staff. The productivity of most dental practices could be improved significantly by becoming better organized, setting goals for the practice, hiring and retaining the right employees, holding properly planned staff meetings, incorporating current computer technology into the practice, and holding in-service educational meetings on a regular basis.

Dr. Gordon Christensen, a Prosthodontist, in Provo, Utah, is Co-founder and Senior Consultant of Clinical Research Associates (CRA). Dr. Christensen is also the Director of Practical Clinical Courses, a continuing education career development program for the dental profession initiated in 1981. He is currently an Adjunct Professor at Brigham Young University and the University of Utah. You can contact Dr. Christensen at: Practical Clinical Courses, 3707 North Canyon Rd., Suite 3D, Provo, Utah 84604-4587. FAX (801) 226-8637. Visit his website at www.gordonchiristensen-pcc.com.

Practical Clinical Courses (PCC) has the following video presentations on the topics discussed above. Each presentation will significantly assist you in achieving better practice administration. You may contact PCC at (800) 223-6569 or visit our website at www.pccdental.com.
V4791–Faster, Easier, Higher Quality Dentistry
V4795–Clinical Tips for Front Desk Personnel
V4788–20 Expanded Function Responsibilities

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